HomeMy WebLinkAboutE2020-0499 - Permits"' v City of Newport Beach - Building Division II�IIIUIIIIIIII�III�III�III�III�IIIIIIIIIIIIIY
o 100 Civic Center Drive, Newport Beach, CA 92660 II
E: '�, �, ' Permit Counter Phone (949)644-3288
"v yam, INSPECTOR
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II Electrical Permit: E2020-0499
Project No : 1169-2020
Inspection Requests Phone (949)644-3255
Job Address: 310 APOLENA AVE Bldg: 1 Floor: Suite:
Description of Work: ELEC TEMP POWER POLE
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Inspector Area: 2
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Code Edit: 2019
Legal Description: BALBOA ISLAND SEC 3 BLK 17 LOT 6
Owner: ROSE DAVID Contractor:
WATERPOINTE CUSTOM HOME
Worker's Compensation Insurance
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Address: 318 AMETHYST AVE Address:
3500 E COAST HWY #110
Carrier: STATE COMP INS
NEWPORT BEACH CA 92662
CORONA DEL MAR CA 92625
Policy No: 1952335
Phone: 9491706-1984 Phone:
949-644-8900
Expire:0510112021 �'
•• o°•°°:
Con State Lie:
947494
•.°•
Issued Date:09/18/2020 Lie Expire:
05/3l/2022
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Bus Lie:
BT314
Processed By:- Lie Exp Date:
OS/31/2021/2021
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New Construction
Receptacle/Switch/Outlets
Residential
Receptacles/Outlets:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Service
Signs
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
0
$0.00
Additional Fee:
$0.00
Fee :
FEES
Motors/Transformers (HP/KVA)
0 to 1 HP/KW/KVA:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
Over 100 HP/KW/KVA:
0
$0.00
Piggy Backrremp Power: 0 $0.00
Temp Power Pole: 1 $41.00
Plan Check Fee:
°
° •
°
°
Temp Underground .....0
°•
••°°°
$0.00
Sub Panel: ....0
$0.00
0
$0.00
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Issuance Fee:
$37.00
Supplemental Fee:
$0.00
e at Permit Issuance:
$78.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
affirm under penaLyof:pedury that I am exempt -from the Contractors" State License Law for thereason(s) indicated below bythe checkmark(s) I have: placed next to the apnilabla dem(s)
I1.5 Business. ant Professions Code: Arty C11yor county that requires a. permit to construct, alter, improve, demolish, or repair any.struchire, pdorto its issuance, also -requires the applicant f0f
License Law
to a Civil penalty of
-1 1., as owner of the property, or my employees with wages as thelrsole compensabon,.wiil do U, all of or U portions of the work,. and the, structure is not intended'.or offered: for sale (Section 7044..
luslness and Professions Coo a: The Contractors' State License Law does not appy, to an ownerofproperty, who, through employeesarpersonali effort;., builds orlmproves.the property, provided that the
nprovements are not latendec. or offered for said. If, however, the building or improvement is sold within one year of completion, the Owner-Buiiderwill have the"burden of provingfhat A was not built or
jroved for the purpose of saa).
I,. as owner of the property, am exclusively contracting with licensed: Contractors: to construct the project (Section 70", Business and Professions Cade: The Comractors' State license Law :does -not
ppy to an owner -of property x ho builds or improves thereon,: and who contracts for the projects with a licensed Contractor pursuant to1he Contractors' State License Law).
3 I am.exempt from: licensurt under the Contrastors`State License Law forthe following reason:. .
,y my signature below I acknowledge that, except for my personal residencein which I must have resided forat least one year prior to completion of the improvements covered; by this permit. .1 cannot'lega
ell a.structurethatrI have built as an owner -binder if ithas not been: constructed In.its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044::of if e;Business and
'rafessiens CDd1% is avoilabte poarequestwhen this application'is submitted oralthe following Web site:AttpJMnwrteginfo.ea.govlcaiaw.htmf.
Ilgnature of Property Owner at Authorized Agent Date..
.ICENSED CONTRACTOR'S DECLARATION
herebyaffirm underpenally o• perjury that I am licensed underprovisdons of Chapter 9(pommeneing with Sectio" 0 Div' ion 3 ofthe Business and Pro ors Co e- nd rqy lir�ense is in full force.
ad effect. Llcense,Cl W, License No D l 20 ContractorSignature L�
WOQKERS COME! MATION DECLARATION
ONE HUNDRED THOUSAND' DOUAaS':($100,o00), IN ADDITION
helqtly,a ft under p%naltyrot perjury one of the following -declarations:
1 have and will maintain• a certificate of consent to self insure, for workers` compensation,' issued by the Director of Industrial Relations as provided for by Section 3700 of :the Labor Code, for
e..��rfopnanctivfthe w'od�c fe�&h ch this permit Is issued. Policy No.
have �d writ mahitaMxro Rers' compensation insurance, as required by Section. 37W of the tabor Code, for the performance of the work for which- this: permit, is issued.. My v,,orkers' compensal
rs rance cagier a5pl= nm Aber are:
.. Phone #
h the Wordia� ices of the work for which this: permit is issued, I shall not employ any person in:any manner so as to become subject to the workers', compensation laws of California, and ogre
)eco s Iect to a work rs- pensation, provisions of 3700 of the.Labor Code,.l shall forthwith Domplywith those. provisions. ����r
'?;M 0 .� h .- � j°"nor-V at r l i
affirm under penalty of perjury that there is a
Name
agency.
1 am the property owner or 3uthor¢ed.to:act•.on the property owner's behalf.
1 have -read this.. application and the information I have. provided Is correct
I agree to comply with all appficabletity and county ordinances and state to,
I authorize representatives cf thiscily orcourgyp enter therpbove_idenlffied
AcnoN I DF.TE'
AWDRULE
PERMIT"WIRED-
CVMFICATEOF..__ -I. ill/a3/,o I. A7— IROPOS D �SEM TION� O I QUCABLE TO
permit:is issued (Sectionr3097,
ONLY